1.Pericyte Plasticity in the Brain.
Gabryella S P SANTOS ; Luiz A V MAGNO ; Marco A ROMANO-SILVA ; Akiva MINTZ ; Alexander BIRBRAIR
Neuroscience Bulletin 2019;35(3):551-560
Cerebral pericytes are perivascular cells that stabilize blood vessels. Little is known about the plasticity of pericytes in the adult brain in vivo. Recently, using state-of-the-art technologies, including two-photon microscopy in combination with sophisticated Cre/loxP in vivo tracing techniques, a novel role of pericytes was revealed in vascular remodeling in the adult brain. Strikingly, after pericyte ablation, neighboring pericytes expand their processes and prevent vascular dilatation. This new knowledge provides insights into pericyte plasticity in the adult brain.
Animals
;
Brain
;
blood supply
;
physiology
;
physiopathology
;
Brain Diseases
;
physiopathology
;
Capillaries
;
physiology
;
Cellular Microenvironment
;
Diabetic Retinopathy
;
physiopathology
;
Endothelial Cells
;
physiology
;
Humans
;
Pericytes
;
physiology
;
Vascular Remodeling
2.A Case of an Isolated Peripheral Giant Cell Granuloma in the Parotid Gland
Soo Jin KIM ; Ju Hyun YUN ; Sohl PARK ; Han Su KIM
Korean Journal of Head and Neck Oncology 2019;35(2):39-43
Peripheral giant cell granuloma (PGCG) is an benign non-neoplastic lesion most commonly occurring in oral cavity but extraoral PGCG is extremely rare. Recently, we experienced a case of an isolated PGCG in the parotid gland in 59-year-old man. FNAB findings and radiologic findings including CT and US were suggestive of Warthin's tumor. Partial parotidectomy was performed. Pathologic findings showed fibrillar connective tissue stroma with spindled, ovoid, and round histiocytes-like cells mixed with uneven multinuclear giant cells, small capillaries, hemorrhage, hemosiderin-laden macrophages, and necrosis which were consistent with giant cell granuloma. We report a case of an PGCG in parotid with a review of literature.
Capillaries
;
Connective Tissue
;
Giant Cells
;
Granuloma, Giant Cell
;
Hemorrhage
;
Humans
;
Macrophages
;
Middle Aged
;
Mouth
;
Necrosis
;
Parotid Gland
3.New prehospital scoring system for traumatic brain injury to predict mortality and severe disability using motor Glasgow Coma Scale, hypotension, and hypoxia: a nationwide observational study
Min Chul GANG ; Ki Jeong HONG ; Sang Do SHIN ; Kyoung Jun SONG ; Young Sun RO ; Tae Han KIM ; Jeong Ho PARK ; Joo JEONG
Clinical and Experimental Emergency Medicine 2019;6(2):152-159
OBJECTIVE: Assessing the severity of injury and predicting outcomes are essential in traumatic brain injury (TBI). However, the respiratory rate and Glasgow Coma Scale (GCS) of the Revised Trauma Score (RTS) are difficult to use in the prehospital setting. This investigation aimed to develop a new prehospital trauma score for TBI (NTS-TBI) to predict mortality and disability.METHODS: We used a nationwide trauma database on severe trauma cases transported by fire departments across Korea in 2013 and 2015. NTS-TBI model 1 used systolic blood pressure < 90 mmHg, peripheral capillary oxygen saturation < 90% measured via pulse oximeter, and motor component of GCS. Model 2 comprised variables of model 1 and age >65 years. We assessed discriminative power via area under the curve (AUC) value for in-hospital mortality and disability defined according to the Glasgow Outcome Scale with scores of 2 or 3. We then compared AUC values of NTS-TBI with those of RTS.RESULTS: In total, 3,642 patients were enrolled. AUC values of NTS-TBI models 1 and 2 for mortality were 0.833 (95% confidence interval [CI], 0.815 to 0.852) and 0.852 (95% CI, 0.835 to 0.869), respectively, while AUC values for disability were 0.772 (95% CI, 0.749 to 0.796) and 0.784 (95% CI, 0.761 to 0.807), respectively. AUC values of NTS-TBI model 2 for mortality and disability were higher than those of RTS (0.819 and 0.761, respectively) (P < 0.01).CONCLUSION: Our NTS-TBI model using systolic blood pressure, motor component of GCS, oxygen saturation, and age was feasible for prehospital care and showed outstanding discriminative power for mortality.
Anoxia
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Area Under Curve
;
Blood Pressure
;
Brain Injuries
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Capillaries
;
Fires
;
Glasgow Coma Scale
;
Glasgow Outcome Scale
;
Hospital Mortality
;
Humans
;
Hypotension
;
Korea
;
Mortality
;
Observational Study
;
Oxygen
;
Quality Improvement
;
Respiratory Rate
4.A Diagnostic Roadmap for Raynaud's Phenomenon
Korean Journal of Medicine 2019;94(5):431-437
Raynaud's phenomenon (RP) is a reversible vasospasm that is aggravated by cold or emotional stress. Before confirming RP, it is essential to consider other possible causes including compressive neuropathy, sensori-neuropathy, thyroid disease, hematologic conditions and offending drugs. RP is typically characterized by the three-step color change that turns pallor (white), cyanosis (blue), and then erythema (red) of reperfusion. Once RP is diagnosed, it is important to determine whether it is primary or secondary RP. To distinguish primary from the secondary RP, the specialized tests performing in clinical practice are antinuclear antibody (ANA) and nailfold capillary microscopy (NFC). The combination of ANA and NFC is most helpful for discriminating secondary RP due to autoimmune rheumatic disease. Thereby, normal findings of NFC in primary RP distinguished from secondary RP should be understood. Patients with primary RP usually improves with symptomatic treatment focused on lifestyle modification and patient education, but those with secondary RP should be treated together with associated disease or causes.
Antibodies, Antinuclear
;
Capillaries
;
Cyanosis
;
Erythema
;
Humans
;
Life Style
;
Microscopic Angioscopy
;
Microscopy
;
Pallor
;
Patient Education as Topic
;
Reperfusion
;
Rheumatic Diseases
;
Stress, Psychological
;
Thyroid Diseases
5.Comparison of Retinal Layer Thickness and Vascular Density between Acute and Chronic Branch Retinal Vein Occlusion
Korean Journal of Ophthalmology 2019;33(3):238-248
PURPOSE: To compare retinal layer thickness and chorioretinal vascular density (VD) between acute and chronic branch retinal vein occlusion (BRVO). METHODS: This study included patients with BRVO. The VD of the superficial capillary plexus (VDs), the VD of the deep capillary plexus (VDd), and VD of the choriocapillaris were obtained using optical coherence tomography angiography. Acute and chronic BRVO data were compared to assess differences between the involved and uninvolved areas. RESULTS: We included 17 eyes with acute BRVO and 23 eyes with chronic BRVO. The VDs in the involved area were not significantly different between the involved area and in the uninvolved area in acute BRVO (p = 0.551). However, the difference was significant in chronic BRVO (p = 0.013). The VDd in the involved area was lower than in the uninvolved area in both acute and chronic BRVO (p = 0.020, p = 0.003, respectively). In addition, the VD of the choriocapillaris values did not differ significantly between acute and chronic BRVO, or between involved and uninvolved areas. The VDs in the involved area in chronic BRVO were lower than in acute BRVO (p = 0.047), and the VDd did not differ between acute and chronic BRVO in all areas. CONCLUSIONS: Vascular impaired patterns in the retinal layer differed between acute and chronic BRVO. These results may suggest that vascular change and remodeling develops differently in acute and chronic phases in BRVO.
Angiography
;
Capillaries
;
Humans
;
Retinal Vein Occlusion
;
Retinal Vein
;
Retinaldehyde
;
Tomography, Optical Coherence
6.Evaluation of Foveal Avascular Zone and Capillary Plexuses in Diabetic Patients by Optical Coherence Tomography Angiography
Emine CILOGLU ; Fikret UNAL ; Emine Alyamaç SUKGEN ; Yusuf KOÇLUK
Korean Journal of Ophthalmology 2019;33(4):359-365
PURPOSE: To investigate the foveal avascular zone (AVZ), superficial and deep foveal and parafoveal vessel density (VD) changes related to diabetic retinopathy. METHODS: Forty-nine type 2 diabetes mellitus (DM) and 45 healthy control subjects were included in this study. The demographic data (age and sex), disease duration, and level of glycated hemoglobin were collected. Superficial VD (%), superficial AVZ area (mm2), deep VD (%) and deep AVZ area (mm2) were evaluated via optic coherence tomography angiography. RESULTS: Superficial AVZ was 0.438 ± 0.05 mm2 in the DM group, 0.246 ± 0.022 mm2 in the control group (p < 0.001). Deep AVZ was 0.732 ± 0.06 mm2 in the DM group, and 0.342 ± 0.022 mm2 in the control group (p < 0.001). Superficial foveal VD was 29.45 ± 0.76 mm2 in the DM group, and 34.86 ± 0.75 mm2 in the control group (p < 0.001). Deep foveal VD was 24.85 ± 1.08 mm2 in the DM group, and 33.47 ± 0.56 mm2 in the control group (p < 0.001). CONCLUSIONS: In this study, we demonstrated an enlargement in the foveal AVZ along with a reduction in the vascular density of the superficial and deep capillary network in the foveal and parafoveal area using optic coherence tomography angiography in patients with nonproliferative diabetic retinopathy. This technique can be used to monitor the progression of the disease and to evaluate the response to treatment.
Angiography
;
Capillaries
;
Diabetes Mellitus, Type 2
;
Diabetic Retinopathy
;
Hemoglobin A, Glycosylated
;
Humans
;
Ischemia
;
Tomography, Optical Coherence
7.Lung Ultrasonography Score as a Respiratory Parameter of Respiratory Distress Syndrome in Very Preterm Infants: A Single Center Experience
So Young SIN ; Jae Hyun PARK ; Chun Soo KIM ; Sang Lak LEE
Neonatal Medicine 2019;26(3):162-168
PURPOSE: Comparison between lung ultrasound (LUS) score and indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. METHODS: We retrospectively reviewed medical records of 32 very preterm infants born at 28 to 31 weeks' gestation at Keimyung University Dongsan Medical Center. Before surfactant administration, bedside LUS in the neonatal intensive care unit was recorded within the first hour of life. Partial pressure of capillary oxygen to fraction of inspired oxygen ratio (PcO2)/FiO2, alveolar-arterial gradient (A-aO2), modified oxygenation index (OI), and arterial to alveolar ratio were calculated. Correlation between LUS score and indices of respiratory severity were analyzed between the intubation and nasal continuous positive airway pressure (NCPAP) groups depending on the presence or absence of endotracheal intubation. RESULTS: Mean LUS scores, A-aO2, and modified OI in the intubation group were significantly higher than those in the NCPAP group. Conversely, PcO2/FiO2 and arterial to alveolar ratios in the intubation group were significantly lower than those in the NCPAP group. LUS score was found to be significantly correlated with A-aO2 (r=0.448, P>0.05) and modified OI (r=0.453, P>0.05), but not with PcO2/FiO2 ratio (r=−0.205, P<0.05) and arterial to alveolar ratio (r=−0.190, P>0.05). CONCLUSION: The LUS score is well correlated with indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. Further investigation is needed to use LUS as an alternative tool in infants with respiratory distress.
Capillaries
;
Continuous Positive Airway Pressure
;
Humans
;
Infant
;
Infant, Newborn
;
Infant, Premature
;
Intensive Care, Neonatal
;
Intubation
;
Intubation, Intratracheal
;
Lung
;
Medical Records
;
Oxygen
;
Partial Pressure
;
Pregnancy
;
Respiratory Distress Syndrome, Newborn
;
Retrospective Studies
;
Ultrasonography
8.Effect of fractional ablative carbon dioxide laser with lidocaine spray on skin flap survival in rats
Manki CHOI ; Youngsoo PARK ; Yong Ha KIM ; Kyu Jin CHUNG
Archives of Craniofacial Surgery 2019;20(4):239-245
BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.
Animals
;
Capillaries
;
Carbon Dioxide
;
Carbon
;
Lasers, Gas
;
Lidocaine
;
Neutrophils
;
Rats
;
Skin
;
Survival Rate
;
Vascular Endothelial Growth Factor A
9.Preclinical Efficacy of V⁴Q⁵dDAVP, a Second Generation Vasopressin Analog, on Metastatic Spread and Tumor-Associated Angiogenesis in Colorectal Cancer
Juan GARONA ; Natasha T SOBOL ; Marina PIFANO ; Valeria I SEGATORI ; Daniel E GOMEZ ; Giselle V RIPOLL ; Daniel F ALONSO
Cancer Research and Treatment 2019;51(2):438-450
PURPOSE: Control of metastatic spread of colorectal cancer (CRC) remains as a major therapeutic challenge. [V4 Q5 ]dDAVP is a vasopressin peptide analog with previously reported anticancer activity against carcinoma tumors. By acting as a selective agonist of arginine vasopressin type 2 membrane receptor (AVPR2) present in endothelial and tumor cells, [V⁴Q⁵]dDAVP is able to impair tumor aggressiveness and distant spread. Our aim was to evaluate the potential therapeutic benefits of [V⁴Q⁵]dDAVP on highly aggressive CRC disease using experimental models with translational relevance. MATERIALS AND METHODS: Murine CT-26 and human Colo-205 AVPR2-expressing CRC cell lines were used to test the preclinical efficacy of [V⁴Q⁵]dDAVP, both in vitro and in vivo. RESULTS: In syngeneic mice surgically implanted with CT-26 cells in the spleen, sustained intravenous treatment with [V⁴Q⁵]dDAVP (0.3 µg/kg) dramatically impaired metastatic progression to liver without overt signs of toxicity, and also reduced experimental lung colonization. The compound inhibited in vivo angiogenesis driven by Colo-205 cells in athymic mice, as well as in vitro endothelial cell migration and capillary tube formation. [V⁴Q⁵]dDAVP exerted AVPR2-dependent cytostatic activity in vitro (IC₅₀ 1.08 µM) and addition to 5-fluorouracil resulted in synergistic antiproliferative effects both in CT-26 and Colo-205 cells. CONCLUSION: The present preclinical study establishes for the first time the efficacy of [V⁴Q⁵]dDAVP on CRC. These encouraging results suggest that the novel second generation vasopressin analog could be used for the management of aggressive CRC as an adjuvant agent during surgery or to complement standard chemotherapy, limiting tumor angiogenesis and metastasis and thus protecting the patient from CRC recurrence.
Animals
;
Arginine Vasopressin
;
Capillaries
;
Cell Line
;
Colon
;
Colorectal Neoplasms
;
Complement System Proteins
;
Drug Therapy
;
Endothelial Cells
;
Fluorouracil
;
Humans
;
In Vitro Techniques
;
Liver
;
Lung
;
Membranes
;
Mice
;
Mice, Nude
;
Models, Theoretical
;
Neoplasm Metastasis
;
Recurrence
;
Robenidine
;
Spleen
;
Vasopressins
10.Effect of Hyperglycemia on Myocardial Perfusion in Diabetic Porcine Models and Humans
Jin Joo PARK ; Sun Hwa KIM ; Myung A KIM ; In Ho CHAE ; Dong Ju CHOI ; Chang Hwan YOON
Journal of Korean Medical Science 2019;34(29):e202-
BACKGROUND: Diabetes mellitus (DM) causes macro- and microvasculopathy, but data on cardiac microvascular changes in large animals are scarce. We sought to determine the effect of DM on macro- and microvascular changes in diabetic pigs and humans. METHODS: Eight domestic pigs (4 with type I diabetes and 4 controls) underwent coronary angiography with optical coherence tomography (OCT; at baseline and 1 and 2 months), coronary computed tomography angiography, cardiac magnet resonance (CMR) imaging, and histologic examination. RESULTS: The diabetic pigs had more irregular capillaries with acellular capillaries and a smaller capillary diameter (11.7 ± 0.33 μm vs. 13.5 ± 0.53 μm; P < 0.001) than those of the control pigs. The OCT showed no significant epicardial stenosis in either group; however diabetic pigs had a greater intima-media thickness. CMR results showed that diabetic pigs had a lower relative upslope at rest (31.3 ± 5.9 vs. 37.9 ± 8.1; P = 0.011) and during stress (18.0 ± 3.0 vs. 21.6 ± 2.8; P = 0.007) than the control pigs, implying decreased myocardial perfusion. Among the 79 patients with ST elevation myocardial infarction, 25 had diabetes and they had lower myocardial perfusion on CMR as well. CONCLUSION: DM causes microvascular remodeling and a decrease in myocardial perfusion in large animals at a very early stage of the disease course. Early and effective interventions are necessary to interrupt the progression of vascular complications in diabetic patients.
Angiography
;
Animals
;
Capillaries
;
Constriction, Pathologic
;
Coronary Angiography
;
Diabetes Mellitus
;
Humans
;
Hyperglycemia
;
Myocardial Infarction
;
Perfusion
;
Sus scrofa
;
Swine
;
Tomography, Optical Coherence

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